Pre-Admission Testing (PAT), sometimes referred to as PreOperative Clearance is a common process in use at hospitals and surgery centers across the nation. When a surgeon sees a patient and determines that surgery is needed, the surgeon will schedule a PAT to make sure that the patient is healthy enough for the surgery and to determine any medication or therapy changes the patient needs prior to surgery (i.e. prophylactic antibiotics or stopping blood thinners). Usually, the surgeon is not qualified to do the PAT. PATs are typically done by physicians with Internal Medicine or Family Practice specialties, since they are trained to look at the patient's entire medical history and current therapies with a much broader perspective than a surgeon who might be focusing on the required surgery for the patient.
PATs serve multiple purposes, including:                1) Making sure the patient is medically ready for the surgery and if the results are inconclusive, to order the necessary follow up tests to determine if the patient is medically ready for the surgery.        2) Making sure that the patient has all the required lab work completed for their surgery and past medical history before the day of surgery.        3) Change medical therapy to prepare the patient for surgery (i.e. stop blood thinners, preoperative antibiotics).        4) Prevent same day surgery cancellations by the anesthesiologist or surgeon due to the patient not being medically ready for the surgery.        
When a surgeon determines that a patient needs surgery, the surgeon will try to schedule a PAT. This is often done through the patient's primary care physician (PCP) or through the hospital or surgery center where the surgery will be performed. Either option can be very difficult for the surgeon and patient. If the surgeon tries to schedule the surgery through the patient's PCP, they can have a hard time getting the patient scheduled for the PAT before the surgery date. Also, the patient's PCP is rarely aware of all the testing requirements of the hospital or surgery center. If the surgeon is lucky enough to get the PCP to see the patient in time, they are often given a PAT from the PCP that will not be accepted by the surgery center or hospital due to the PCP's unfamiliarity with surgery center or hospital's PAT requirements. Even when the PCP can get the patient scheduled in time and delivers a complete PAT, the burden is on the surgeon's office to make sure that the PCP's PAT report and all necessary lab results are forwarded to the surgery center or hospital.
If the patient's PCP is unable or unwilling to do the PAT, the surgeon can sometimes turn to the hospital's PAT department to have a physician supplied by the hospital complete the patient's PAT (surgery centers typically do not have a high enough volume to make supplying their own PAT clinic feasible). Unfortunately, most hospitals PAT clinics are designed around the hospital's needs and not the surgeon's or patient's. This can result in a cumbersome PAT scheduling process where the surgeon's office calls the PAT clinic only to have to leave a voicemail. When the PAT clinic calls back, the patient is no longer in the surgeon's office and now the surgeon's office is forced to play “phone tag” with the patient and act as an unnecessary middle man to schedule the patient for their PAT. The PAT clinic's report is rarely in an easy to read format for the surgeon and the responsibility for follow up testing is often left to the surgeon instead of the PAT clinic. Finally, if the surgeon operates at multiple hospitals, they have multiple PAT clinics and procedures that they need to deal with.
The present system is designed to streamline the PAT process for the surgeon, patient, and surgical facility. The components of the system preferably support multiple surgical specialties and surgical facilities and are aware of requirements unique to each surgeon and/or surgical facility. The system can be utilized by a PAT clinic to significantly improve the PAT experience for all stakeholders.
When a surgeon decides to utilize a PAT clinic that uses the invention of the present invention, their experience is vastly improved. First, when the surgeon decides to schedule a patient for surgery, they preferably go to an on-line web site such as www.patclinic.com to enter basic demographic information about the patient and their surgery as well as schedule a PAT time. In some cases, the PAT must be done that day (i.e. the patient is from out of town and doesn't want to make a special trip back or the surgery is scheduled within the next few days). If the PAT must be done the same day, the system text pages the PAT physician and ancillary staff to prepare them for the patient's arrival. At the completion of the PAT scheduling process, the web site prepares patient handouts describing how to get to the PAT clinic and a medical history form for the patient to fill out. The medical history form also gives the patient an access key so they can fill out the medical history form on-line if they so choose.
Every day, the PAT clinic staff log into the on-line web interface of the system where it provides them with an appointment confirmation call list so they can call patients on the PAT schedule for the next business day so they can confirm their appointment and answer any questions they might have. The staff can enter any comments and the disposition of their call attempts (i.e. confirmed, left message, no answer).
When the patient enters the PAT clinic, the physician can utilize a PAT electronic medical record (EMR) tool or module to look up all available information about the patient. If the patient completed their medical history questionnaire online, that information can be accessed through the physician's PAT EMR module. If the patient did not complete the medical history questionnaire online, the physician or their designee manually enters it into the PAT EMR module. At this point, the physician can determine if the patient needs an EKG. If they do, ancillary staff perform the EKG and electronically transfer it to the PAT EMR module. At this point, the physician examines the patient and uses the tools provided by the EMR module to order the required lab tests and clear the patient for surgery based on the latest evidence based guidelines.
At the end of the visit, the EMR preferably prints a list of lab test prescriptions for the patient along with instructions as to where they can have the testing performed. The patient has their blood drawn and any other required testing completed. In the preferred embodiment, the lab results are automatically sent by the lab electronically to the PAT EMR system via Internet based web services.
Once all the lab tests are back, the PAT physician can: 1) Clear the patient for surgery or 2) Order more follow up tests if the first round of testing revealed significant abnormalities or 3) Cancel the patient's surgery. Once the PAT physician has made the final determination, they mark the visit complete at which point, the system automatically prepares reports that are faxed to the surgery center. These same reports are available to the surgeon's office via www.patclinic.com. The completed visit is also automatically submitted for billing to the patient's insurance carrier.
These and other advantages of the present invention are provided by: a system for scheduling pre-admission testing, comprising: an on-line interface adapted to allow scheduling of pre-admission testing (PAT) and access of PAT reports; a database for storing PAT scheduling information; an electronic module adapted to retrieve information stored on the system including PAT scheduling information, the electronic module also adapted to input patient information for storage in the system; and wherein the system allows users to connect to the on-line interface from remote locations and is adapted to allow surgeons or their offices to schedule PAT appointments and to access said PAT reports through the on-line interface.
In the preferred embodiment, the on-line interface is adapted to allow the input of patient demographic and medical information from a remote location for storage in the system prior to the PAT appointment. The system is preferably adapted to allow retrieval of the patient demographic and medical information from the physician's electronic module. The system is preferably adapted to provide an access key to users for use in inputting patient demographic and medical information from a remote location.
Obvious modifications to the present invention are expected to fall within the scope of the claims of the present invention. The above stated and other advantages of the present invention will be better understood from the following description of the drawings and detailed description of the preferred embodiment(s).